Provider Demographics
NPI:1124104732
Name:NARVAEZ, ALEJANDRO M (DDS)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:M
Last Name:NARVAEZ
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0112
Mailing Address - Fax:206-764-0489
Practice Address - Street 1:8915 14TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-4813
Practice Address - Country:US
Practice Address - Phone:206-762-3263
Practice Address - Fax:206-762-6574
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00005742122300000X, 1223X0400X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANA6237OtherREGENCE BLUE SHIELD
WA0174702OtherSTATE LABOR & INDUSTRIES
WA5002654Medicaid